Provider Demographics
NPI:1427039437
Name:ZEEGEN, ERIK N (MD)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:N
Last Name:ZEEGEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5525 ETIWANDA AVE
Mailing Address - Street 2:SUITE 324
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3647
Mailing Address - Country:US
Mailing Address - Phone:818-708-9090
Mailing Address - Fax:818-708-3901
Practice Address - Street 1:5525 ETIWANDA
Practice Address - Street 2:STE 324
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91436-3647
Practice Address - Country:US
Practice Address - Phone:818-708-9090
Practice Address - Fax:818-708-3901
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64195207X00000X, 207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A641950Medicaid
CAAM641Medicare PIN
CAH62306Medicare UPIN
CA00A641950Medicaid